Among patients with acute pain who can take oral medications, does parenteral ketorolac reduce pain more or faster than oral NSAIDs

A living systematic review

Short url: https://openmetaanalysis.github.io/pain-ketorolac

Clinical summary: This meta-analysis suggests that parenteral ketorolac is not more effective. Heterogeneity of results as measured by I² was 'low' at 0%, but the confidence intervals were very wide.

Methods overview: This repository is an openMetaAnalysis that combines methods of scoping, rapid, and living systematic reviews. This analysis updates one or more previously published review(s) below (none found). Newer studies included are listed in the references below. Rationales for newer trials excluded may be listed at the end of the references.

• Methods for openMetaAnalysis
• Evidence search for this review (under construction)

Results: Details of the studies included are in the:

• Forest plots (spreadsheets with source data)

The forest plot for the primary outcomes are below. Additional forest plots of secondary analyses may be available.

References:

Systematic review(s)

Most recent review at time of last revision of this repository

None found

Randomized controlled trials

New trial(s) not included in the most recent review above

1. Turturro MA, Paris PM, Seaberg DC. Intramuscular ketorolac versus oral ibuprofen in acute musculoskeletal pain. Ann Emerg Med. 1995 Aug;26(2):117-20. doi: 10.1016/s0196-0644(95)70138-9. PMID: 7618770.
2. Shrestha M, Morgan DL, Moreden JM, Singh R, Nelson M, Hayes JE. Randomized double-blind comparison of the analgesic efficacy of intramuscular ketorolac and oral indomethacin in the treatment of acute gouty arthritis. Ann Emerg Med. 1995 Dec;26(6):682-6. doi: 10.1016/s0196-0644(95)70037-4. PMID: 7492036.
3. Neighbor ML, Puntillo KA. Intramuscular ketorolac vs oral ibuprofen in emergency department patients with acute pain. Acad Emerg Med. 1998 Feb;5(2):118-22. doi: 10.1111/j.1553-2712.1998.tb02595.x. PMID: 9492131.
4. Engel ER, Cheng J. IM ketorolac vs diclofenac potassium powder for oral solution for the acute treatment of severe migraine: a randomized controlled trial. Neurol Sci. 2020 Mar;41(3):537-542. doi: 10.1007/s10072-019-04157-y. Epub 2019 Dec 12. PMID: 31833000.

Trial(s) included in the review above

NA

Trial(s) undergoing review

None

Trial(s) excluded - selected list of important trial(s)

1. Wright JM, Price SD, Watson WA. NSAID use and efficacy in the emergency department: single doses of oral ibuprofen versus intramuscular ketorolac. Ann Pharmacother. 1994 Mar;28(3):309-12. doi: 10.1177/106002809402800301. PMID: 8193414. Not randomized

Cited by

This repository is cited by:

1. WikiDoc contributors. Pending content page. WikiDoc. Nov 9, 2014. Available at: http://www.wikidoc.org/index.php/This_topic. Accessed November 9, 2014.

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